Individual provider Active NPI

Spring Elaine Cornavaca, CRNA

  • Certified Registered Nurse Anesthetist
  • Chattanooga, TN
National Provider Identifier
1215949326
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN169392 Issued in GA
Practice address
975 E. Third Street
Chattanooga, TN 37403-2147
Phone
(423) 778-7608
Fax
(423) 778-2360
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN169392 GA
Registered Nurse 163W00000X RN124955 TN
Certified Registered Nurse Anesthetist 367500000X RN169392 GA Primary

Addresses

Primary practice location

975 E. Third Street
Chattanooga, TN 37403-2147

Mailing address

PO Box 11225
Chattanooga, TN 37401-2225
Phone (423) 892-5602

Other identifiers 7

IdentifierTypeStateIssuer
4156966OtherTNBLUE CROSS BLUE SHIELD OF TN
P00430484OtherRAILROAD MEDICARE
N356383OtherGAWELLCARE (GA MEDICAID)
009911539MedicaidAL
8052759MedicaidNC
3638075MedicaidTN
453654394AMedicaidGA

Other names 1

  • Spring Elaine Wildman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170105000909 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395849632 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentry Anesthesia Management, LLCGroup PAC ID 9436372323, 170 clinicians

Practice addresses (Care Compare)

126 US Hwy 280 W
Americus, GA 31719-8645
Phone (229) 924-6011

705 Jesse Jewell Pkwy SE
Suite 125
Gainesville, GA 30501-3824
Phone (678) 207-4000

Merit-based Incentive Payment System (MIPS)

Final score
73.38 of 100Reported as group
Quality
77.5
Improvement activities
20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN169392GAMDRegistered Nurse
RN124955TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Ambulatory Anesthesia LLC CurrentSince Nov 17, 2021 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Feb 23, 2023 Accepting new patients
Gastroenterology Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2021 Accepting new patients
Anesthesia Care Services, PA Nurse Anesthetist, Certified Registered CurrentSince May 1, 2018 Accepting new patients
Lunate Surgery Center CurrentSince Jun 27, 2022 Accepting new patients
Ahs Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 2, 2016 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Gi Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2021 Accepting new patients
Forsyth Eye Surgery Center, LLC Past Accepting new patients
Carpus Surgery Center LLC PastSince Nov 5, 2016 Accepting new patients
Ulna Surgery Center LLC PastSince Apr 3, 2017 Accepting new patients
Buford Eye Surgery Center Past Accepting new patients
Alpharetta Eye Surgery Center LLC Past Accepting new patients
Ahs Surgery Center Canton LLC PastSince Nov 5, 2016 Accepting new patients
Roswell Eye Surgery Center, LLC Past Accepting new patients

Locations (25 of 30)

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

340 N Milledge Ave
Ste A
Athens, GA 30601
Phone (706) 548-0008

195 King Ave
Athens, GA 30606
Phone (706) 543-6261

1500 Oglethorpe Ave
Ste 500B
Athens, GA 30606
Phone (706) 548-5833

550 Peachtree St NE
Ste 1600
Atlanta, GA 30308
Phone (404) 881-1094

1515 River Pl
Ste 320
Braselton, GA 30517
Phone (678) 997-2125

201 Kimberly Way
Ste 100
Canton, GA 30114

2675 N Decatur Rd
Ste 506
Decatur, GA 30033
Phone (404) 299-1679

8855 Hospital Dr
Ste 102
Douglasville, GA 30134
Phone (678) 784-5020

1240 Jesse Jewell Pkwy SE
Ste 360
Gainesville, GA 30501
Phone (770) 534-9420

705 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 532-9639

2324 Limestone Overlook
Ste 200
Gainesville, GA 30501
Phone (312) 724-7441

1955 Textile Way
Gainesville, GA 30501
Phone (678) 987-1499

226 E College St
#A
Griffin, GA 30224
Phone (678) 987-1490

1101 Old Philadelphia Rd
Ste G200
Jasper, GA 30143
Phone (205) 422-5189

10730 Medlock Bridge Rd
Ste 210
Johns Creek, GA 30097

600 Professional Dr
Ste 150
Lawrenceville, GA 30046
Phone (678) 376-1800

4865 Bill Gardner Pkwy
Locust Grove, GA 30248
Phone (770) 692-0100

488 Kennesaw Ave NW
Ste 100
Marietta, GA 30060
Phone (770) 427-3075

3775 Roswell Rd
Ste 275
Marietta, GA 30062

34 Upper Riverdale Rd SE
Ste 201
Riverdale, GA 30274
Phone (678) 904-0094

6115 Peachtree Dunwoody Rd
Ste 230
Sandy Springs, GA 30328

5671 Ptree Dunwoody Rd NE
Ste 680
Sandy Springs, GA 30342
Phone (404) 705-6985

1139 Lexington Ave
Savannah, GA 31404
Phone (912) 303-4200

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1215949326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11225",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374012225",
            "telephone_number": "423-892-5602",
            "fax_number": "423-892-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E. THIRD STREET",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147",
            "telephone_number": "423-778-7608",
            "fax_number": "423-778-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNAVACA",
        "first_name": "SPRING",
        "middle_name": "ELAINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN169392",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN124955",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN169392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TN",
            "identifier": "4156966",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00430484",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE (GA MEDICAID)",
            "identifier": "N356383",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009911539",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052759",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3638075",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "453654394A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SPRING",
            "last_name": "WILDMAN",
            "middle_name": "ELAINE",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.